1984 Volume 35 Issue 3 Pages 269-273
A case of esophageal mucosal carcinoma resected by a blunt dissection is reported.
A 75-year-old man visited a local physician with a complaint of loss of appetite. Esophagogram showed slight deformity at the distal esophagus which implies a compression by enlarged heart. Upper G-I endoscopy revealed an erosion in the lower esophagus. Histologic study of bite biopsy specimens showed severe dysplasia. He was admitted to the Institute of Gastroenterology, Tokyo Women's Medical College for further examination. A small eroding lesion among irregularly thickened mucosa in the distal esophagus was found by esophagofiberscopy. Endoscopic staining method aided by Lugol's solution delineated a broad unstained area.
For his poor condition due to past cerebral thrombosis with hemiplegia and myocardial infarction, thoracotomy was not indicated. Esophagectomy by a blunt dissection without thoracotomy was performed with subsequent ante-thoracic esophagogastrostomy.
Histologic study of the resected specimen showed squamous cell carcinoma limited within the mucosal layer. There foumd no lymph node metastasis among those removed from the abdomen and lower mediastinum.
Seven cases of mucosal carcinoma of the esophagus underwent radical resection at our Institute, all of which were diagnosed as mucosal carcinoma through preoperative examinations and showed no lymph node metastasis. Thus the present case was expected to be one of early esophageal carcinoma. For possible lymphatic invasion, the patient was strictlly followed and showed no sign of recurrence for two years after the operation
